Is Surgical Treatment Necessary for the Treatment of a Jones Fracture?: A Retrospective Study.

Background: Jones fractures are common injuries that can be treated conservatively or surgically. However, the optimal treatment approach remains controversial. This study aimed to compare the clinical outcomes of conservative and operative treatments for Jones fractures and determine whether surgical treatment is necessary. Methods: A retrospective study was conducted on 69 patients with Jones fractures treated at our hospital. The patients were divided into 2 groups: conservative (C group; n = 46) and operative (O group; n = 23) treatments. Patients were followed up after 2, 6, and 12 weeks, and every 3 months thereafter. However, outpatient follow-ups were conducted between 8 and 10 weeks as needed. The mean follow-up period was 14.5 weeks (range, 12-24 weeks). In group C, the patients were treated with a non-weight-bearing cast for 4-6 weeks, followed by additional weight-bearing boot immobilization before returning to exercise. In group O, patients were treated surgically using a bicortical screw or intramedullary internal fixation. Time to radiologic union, clinical union, return to sports, visual analog scale (VAS), Foot Function Index-Revised Short Form (FFI-RS), and American Orthopedic Foot and Ankle Society (AOFAS) scores were evaluated. Results: Sixty-nine patients were included in the analysis. There were statistically significant differences in the time to radiologic union and return to sports, VAS score in the second week, and FFI-RS score in the 12th week. In group C, favorable outcomes were observed in terms of the time to return to sports, VAS score in the second week, and FFI-RS score in the 12th week. Contrastingly, in group O, better results were observed in time to radiologic union. The AOFAS score was excellent at the final follow-up, with no significant differences between groups. Complication rates were 10.8% and 13% in groups C and O, respectively. Conclusions: Surgical treatment is sometimes necessary for Jones fractures, but conservative treatment should also be considered because of the favorable outcomes. Conservative treatment can be a good option for patients who are risk-averse and place a high value on fracture healing without surgery.

Jiella pelagia sp. nov., isolated from the phosphonate-amended seawater of the northwestern Pacific Ocean.

A novel Gram-stain-negative, aerobic, rod-shaped bacterium, designated as HL-NP1T, was isolated from the surface water of the northwestern Pacific Ocean after enrichment cultivation using the organic phosphorous compound of 2-aminoethylphosphonate. Phylogenetic analysis based on 16S rRNA gene sequences showed that the strain belonged to the genus Jiella, with the highest similarity to Jiella pacifica 40Bstr34T (98.7 %). The complete genome sequence of strain HL-NP1T comprised a circular chromosome of 5.58 Mbp and two circular plasmids of 0.15 and 0.22 Mbp. Comparison of the genome sequences between strains HL-NP1T and J. pacifica 40Bstr34T revealed that average nucleotide identity, average amino acid identity and digital DNA-DNA hybridization values (88.0, 86.4 and 33.9 %, respectively) were below the recommended cut-off levels for delineating bacterial species. Strain HL-NP1T showed optimal growth at 30 °C, pH 6.5-7.0, with 2.0-2.5 % (w/v) NaCl. The sole respiratory quinone was ubiquinone-10. The predominant fatty acid was summed feature 8 (C18 : 1 ω6c and/or C18 : 1 ω7c). The polar lipids comprised diphosphatidylglycerol, phosphatidylcholine, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylmonomethylethanolamine, an unidentified aminolipid and four unidentified lipids. The G+C content of the genomic DNA was 65.1 %. Based on phylogenetic, genotypic, phenotypic and chemotaxonomic data, strain HL-NP1T is proposed to represent a novel species of the genus Jiella, for which the name Jiella pelagia sp. nov. is proposed. The type strain is HL-NP1T (= KCCM 90499T = JCM 35838T).

Roseovarius pelagicus sp. nov., a facultatively anaerobic bacterium with potential for degrading polypropylene, isolated from Arctic seawater.

A Gram-stain-negative, facultatively anaerobic, non-motile, rod-shaped bacterial strain, designated HL-MP18T, was isolated from Arctic seawater after a prolonged incubation employing polypropylene as the sole carbon source. Phylogenetic analyses of the 16S rRNA gene sequence revealed that strain HL-MP18T was affiliated to the genus Roseovarius with close relatives Roseovarius carneus LXJ103T (96.8 %) and Roseovarius litorisediminis KCTC 32327T (96.5 %). The complete genome sequence of strain HL-MP18T comprised a circular chromosome of 3.86 Mbp and two circular plasmids of 0.17 and 0.24 Mbp. Genomic comparisons based on average nucleotide identity and digital DNA-DNA hybridization showed that strain HL-MP18T was consistently discriminated from its closely related taxa in the genus Roseovarius. Strain HL-MP18T showed optimal growth at 25 °C, pH 7.0 and 2.5 % (w/v) sea salts. The major cellular fatty acids were C18 : 1 ω6c and/or C18 : 1 ω7c (49.6 %), C19 : 0 cyclo ω8c (13.5 %), and C16 : 0 (12.8 %). The major respiratory quinone was ubiquinone-10. The polar lipids consisted of phosphatidylcholine, phosphatidylglycerol, an unidentified aminolipid and three unidentified lipids. The genomic DNA G+C content of the strain was 59.2 mol%. The phylogenetic, genomic, phenotypic and chemotaxonomic results indicate that strain HL-MP18T is distinguishable from the recognized species of the genus Roseovarius. Therefore, we propose that strain HL-MP18T represents a novel species belonging to the genus Roseovarius, for which the name Roseovarius pelagicus sp. nov. is proposed. The type strain is HL-MP18T (=KCCM 90405T=JCM 35639T).

Maribacter litopenaei sp. nov., isolated from the intestinal tract of the Pacific white shrimp Litopenaeus vannamei.

A Gram-stain-negative, aerobic, rod-shaped bacterial strain, designated HL-LV01T, was isolated from the intestinal tract content of the Pacific white shrimp Litopenaeus vannamei. The 16S rRNA gene sequence of strain HL-LV01T showed that the strain was clearly a member of the genus Maribacter. According to the phylogenetic analyses, strain HL-LV01T was most closely related to the species Maribacter flavus KCTC 42508T with 98.2 % sequence similarity. The average nucleotide identity and digital DNA-DNA hybridization values between strain HL-LV01T and M. flavus KCTC 42508T were 80.6 % and 23.0 %, respectively, indicating different genomic species in the genus Maribacter. Strain HL-LV01T showed optimal growth at 35 °C, pH 7.0, and 2.5 % (w/v) sea salts. The major cellular fatty acids were iso-C15 : 0 (32.5 %), iso-C17 : 0 3-OH (22.3 %), and iso-C15 : 1 G (15.5 %). The major respiratory quinone was menaquinone-6. The polar lipids consisted of phosphatidylethanolamine, three unidentified aminolipids, and seven unidentified lipids. The genomic DNA G+C content of the strain was 39.8 mol%. The comprehensive phylogenetic, genomic, phenotypic, and chemotaxonomic results indicate that strain HL-LV01T is distinct from validly published species of the genus Maribacter. Hence, we propose strain HL-LV01T as a novel species belonging to the genus Maribacter, for which the name Maribacter litopenaei sp. nov. is proposed. The type strain is HL-LV01T (= KCCM 90498T = JCM 35709T).

Studies on the Anti-Angiogenic Activities of Wild and Cultivated Orostachys japonicus Extracts in Human Umbilical Vein Endothelial Cells.

Orostachys japonicus has traditionally been used as a food product and a fork medicine in Asia to treat various diseases. Angiogenesis is a critical process that contributes to various chronic diseases via excessive delivery of oxygen and nutrients. Common anti-angiogenic drugs have serious problems related to high costs and side effects; thus, natural products with low costs and no cytotoxicity have garnered increasing interest. In this study, we evaluated and compared the anti-angiogenic effects and phenolic compound contents between wild (WOEs) and cultivated O. japonicus extracts (COEs) prepared under various extract conditions. WOEs and COEs suppressed cell proliferation of human umbilical vein endothelial cells (HUVECs) and inhibited vascular endothelial growth factor-induced chemotactic migration, invasion, and capillary-like tube formation in HUVECs. Among COEs, that prepared by 70% EtOH (70% CE) showed the most effective anti-angiogenic activity in HUVECs. When compared to WOEs, total polyphenol and total flavonoid contents were 1.28 to 4.38 times higher in COEs, and 70% CE contained the greatest flavonoid contents (28.28 ± 0.93 mg%), as well as the highest levels of major phenolic compounds including gallic acid (21.84 µg/mL), epicatechin-gallate (6.58 µg/mL), kaempferol (6.32 µg/mL), and quercetin (8.55 µg/mL). Although further studies are required to identify the molecular mechanisms behind these anti-angiogenic effects, 70% CE could be used as an herbal medicine, functional food ingredient, and potent angiogenesis inhibitor. PRACTICAL APPLICATION: Environmental factors such as altitude, nutrients, exposure to sunlight, and temperature can influence the type and quantity of bioactive components in plants. The advantage of cultivated plants is that the above-mentioned factors can be artificially adjusted compared to wild plants. Based on economic efficiency, productivity, and consistent quality, anti-angiogenesis activity of cultivated O. japonicus is of greater commercial value as a functional food than wild O. japonicus.

An evaluation of the effectiveness of hyaluronidase in the selective nerve root block of radiculopathy: a double blind, controlled clinical trial.

STUDY DESIGN: Prospective, double-blind, randomized controlled trial. PURPOSE: To determine the ability of hyaluronidase to provide longer lasting pain relief and functional improvement in patients with lumbar radiculopathy. OVERVIEW OF LITERATURE: Selective nerve root block (SNRB) is a good treatment option in lumbar radiculopathy. We studied the effectiveness of hyaluronidase when added to the traditional SNRB regimen. METHODS: A sample size of 126 patients per group was necessary. A sample of 252 patients who underwent an injection procedure with or without hyaluronidase due to radiculopathy was included in this study. The patients were randomly divided into two groups: the control (C) group and the hyaluronidase (H) group. After SNRB due to radiculopathy, the visual analog scale (VAS) was compared at 2, 4, 6, 8, and 12 weeks between the two groups, and the Oswestry disability index (ODI) was compared at 12 weeks between the two groups. RESULTS: Both groups seemed to have general improvement in VAS, but in C group, the VAS was higher than the H group 2 and 4 weeks after the surgery, and the difference in time-group change between 2 groups was statistically significant (p <0.05). ODI improved in both groups, and the difference in time-group change between 2 groups was not statistically significant (p >0.05). CONCLUSIONS: The rebound pain (the re-occurrence of pain within 2-4 weeks after injection) that occurs within 2-4 weeks after the injection of the routine regimen can be reduced when hyaluronidase is added to the routine SNRB regimen.

Synergistic effect of rhein in combination with ampicillin or oxacillin against methicillin-resistant Staphylococcus aureus.

Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium responsible for a number of infections in humans that are difficult to treat, and as a result, is a substantial contributor to morbidity and mortality. In the present study, in search of natural products capable of inhibiting this multidrug-resistant bacterium, we investigated the antimicrobial activity of rhein isolated from Rheum palmatum L. (Polygonaceae) against 16 different strains of the bacterium. New antimicrobial activity was found using the paper disc diffusion method [minimal inhibitory concentrations (MICs)], MTT test and checkerboard dilution test. Against the 16 strains, the disc diffusion test was in the range of 20-29 mm and the MICs of rhein were in the range of 7.8-31.25 µg/ml. From these results we performed the checkerboard test to determine the synergism of rhein in combination with ampicillin (AM) or oxacillin (OX) against all strains. The combined activity of rhein and the two antimicrobial agents (AM and OX) against all strains resulted in a fractional inhibitory concentration index ranging from 0.28-1 and from 0.18-1, respectively. The effect of rhein with AM and OX was found to be synergistic or partially synergistic. We found that rhein reduced the MICs of AM and OX. Rhein in combination with AM or OX could lead to the development of new combinations of antibiotics against MRSA infection.

Antibacterial and synergistic effects of Smallanthus sonchifolius leaf extracts against methicillin-resistant Staphylococcus aureus under light intensity.

Smallanthus sonchifolius (yacon) is a perennial plant mostly cultivated in South America, primarily for use of the tubers as a food crop and the leaves as fodder for livestock. The antibacterial activities of the methanol extract of yacon leaves (S. sonchifolius) and its n-hexane, ethyl acetate, n-butanol and water fractions were evaluated against 6 strains of methicillin-resistant Staphylococcus aureus (MRSA) and 1 standard methicillin-susceptible S. aureus (MSSA) strain by using the disc diffusion method and minimal inhibitory concentrations (MICs) assay in the presence and absence of light. No activity was detected when the two methods were performed without light; however, under illumination at 4000 lux, the n-hexane fraction of yacon (HFY) had a MIC of 15.6 microg/ml. HFYL, prepared by exposure of HFY to 4000 lux for 18 h, was more effective than HFY in terms of antimicrobial activity against the 6 MRSA strains and 1 standard MSSA strain. HFYL mixed with ampicillin or oxacillin showed a synergistic effect with all fractional inhibitory concentrations values being below 0.5. The present study demonstrates the enhancement and antimicrobial activity of yacon leaves against MRSA in the presence of light.